Psychiatric Nursing LECTURE - Id = want/pleasure principle
- Superego = moral principle (right thing
Subject aka: Maladaptive Patterns of
Behavior to do)
TOPIC: Concepts of Mental Health and Illness 4. Autonomy (Dependence vs.
Independence)
Mental Health
- has the capability to decide for
- a state of well-being in which the individual
ourselves, but there are also times that
realizes his or her own abilities, can cope
we need help from others.
with the normal stresses of life, can work
productively and fruitfully, and is able to
5. Reality Perception (Challenge vs.
make a contribution to his or her community.
Punishment; Motivation vs. Frustration)
(WHO definition)
- has the ability to acknowledge which is
**well-being refers to all aspects.
the reward and the punishment.
**as long as we can cope up in spite of
the stressors, we are in good state of mental
6. Environmental Mastery (Adaptation)
health.
- we tend to master the different factors
- ability of a person to look at his self
surrounding us (the environment that
positively in relation to his role and identified
can cause stress)
existence in society.
**we still have a positive outlook in life
despite presence of stressors.
Mental Illness
- any deviation from what is perceived to be
normal behavioral pattern.
6 Indicators of Mental Health
- failure of a person towards realistic and
1. Positive attitude towards self (Self-
independent means of self-control and
awareness)
coping with the stressors brought about by
- acknowledge that you can do it
different factors.
2. Growth, development, and self-
actualization
- in Maslow’s Hierarchy of Needs, 2nd-5th
levels are related to mental health
3. Integration (Fantasy vs. Reality; Id vs.
Superego)
- fantasy = ideal type
batang_gas
, Psychiatric Nursing LECTURE
TOPIC: Stress and Crisis
Stress - stimulus that produces distress and
creates physical and psychological demands
on an individual, requiring coping and
adapting.
Maladaptive behaviors come from the
inability to cope or adapt to stress.
2. Stage of Resistance
General Adaptation Syndrome (GAS) - physiologic adaptation that attempt to
- by Hans Selye limit damage of stress by stimulating the
- “stress as wear and tear of the body parasympathetic nervous system
occurring regardless of whether the stressor (negative feedback)
is positive or negative.”
3. Stage of Exhaustion
- predictable in terms of s/sx - depletion of physiologic and
- sympathetic, parasympathetic and psychologic resources resulting to failure
endocrine regulates stress response of physiologic process, immune
suppression, diseases, and worst, death.
STAGES:
1. Alarm Reaction
- fight or flight response
How do you cope up with stress?
- reaction of the sympathetic nervous
system and endocrine system to a COPING STRATEGIES
stressor
- 2 classifications: Acute Stress and Coping Strategies (Stress Reduction)
Chronic Stress o Social support
o Self-discipline and perseverance –
help yourself bro
o Vent out strong emotions – the
more you release it, the more eased
that you become (let it go)
o Think of options and problem-
solving techniques
o Physical activities and exercise
o Relaxation techniques (music, warm
bath, meditating, imagery, muscle
relaxation)
Crisis – overwhelming reaction to a stressor
(threatening) where the pt’s problem-
batang_gas
, solving skills is beyond their ability to cope,
adjust, solve, and handle.
It lasts for about 4-6 weeks.
TAKE NOTE:
o All individuals experience problems and
crisis at one time or another.
o Crisis is determined by the individual’s
perception of the problem because each
one uniquely responds to problems.
o Crisis is not necessarily pathological; it
can also stimulate growth and learning. Signs and Symptoms of Crisis:
Physical
Crisis Development (stages):
o Somatic complaints (headache, GI
1. Precrisis period
pain or upset)
- state of emotional equilibrium;
o Appetite disturbance & wt. loss
exposure to stressors but the person
o Sleep disturbances (nightmares,
does not react yet
insomnia)
2. Impact period
o Restlessness, irritability
- failure of coping mechanisms and
Cognitive
manifestations of symptoms of high
o Confusion, difficulty concentrating
level of stress
o Racing thoughts
- inability to reason logically
o Can’t’ make decisions
3. Crisis period
Behavioral
- use of coping skills to deal with the
o Disorganization, withdrawn
stressor (denial, rationalization,
o Impulsive, angry outbursts
projection)
o Difficulty carrying out roles
4. Resolution period
Emotional
- (+) coping = integration; positive
o Anxiety, anger, guilt
perception over crisis; decreased anxiety
o Sadness, depression
and increased self-esteem; resume
o Paranoia, suspicion
social role
o Helplessness, powerlessness
- (-) coping = disequilibrium = tension,
anxiety, depression, self-hate,
decreased self-esteem
5. Post-crisis period Nursing Process: Crisis
- resolution of crisis and return to the Assessment
baseline state of physical and mental
health Types and Cause of Crisis:
- new coping skills 1. Situational – occurs in response to a
sudden, unexpected event that revolve
around experience of loss.
2. Developmental/Maturational – occurs as
part of growth and development transition
batang_gas
, 3. Adventitious – occurs in severe trauma or - active but temporary entry into the life
catastrophic disasters situation of an individual, family, or group during
a period of stress
Based on Severity of Crisis:
- attempt to resolve an immediate crisis when a
1. Class I: Dispositional or Situational Crisis
person’s life goals are obstructed and usual
– acute response with immediate action
problem-solving methods fail
2. Class II: Transitional or Maturational
Crisis – occurs during normal growth and - DIRECT & SUPPORTIVE INTERVENTION
development
3. Class III: Traumatic Crisis – sudden, Direct intervention – take temporary control
unexpected, external stress (loss of home for the situation (you do it for them)
during earthquake, rape) Supportive intervention – collaborative and
4. Class IV: Maturational or Developmental non-directive
Crisis – internal and psychosocial issues
(sexual identity, inability to achieve Crisis Interventions
independence) Establish rapport by active listening
5. Class V: Situational d/t Preexisting Utilize previous effective coping mechanism
Psychopathology – (depression, anxiety) Separate other concerns and solve the
6. Class VI: Psychiatric Emergency – current issue
(attempted suicide, drug overdose, extreme Determine and reinforce correct patterns of
agitation…) thought
Activate the patient’s support system
Characteristics of Crisis: Explore the patient’s idea on self-harm,
o Self-limiting (4-6 weeks) mutilation, or suicide intent (perform suicide
o Resolved in 3 ways: precautions)
- return to pre-crisis functioning
- lead to higher level of functioning PHARMA: anxiolytics (benzodiazepines,
- regress at a lower level of neuroleptics)
functioning
Coping Factors
o Personal perception on the
magnitude of the problem
o Previous experience in managing
and adjusting to the problem
o Coping mechanism and stress mgt.
o Support systems: social or financial
Diagnosis: identify the problem
Outcome: relieve the crisis by promoting coping
mechanism
Crisis Intervention
batang_gas
- Superego = moral principle (right thing
Subject aka: Maladaptive Patterns of
Behavior to do)
TOPIC: Concepts of Mental Health and Illness 4. Autonomy (Dependence vs.
Independence)
Mental Health
- has the capability to decide for
- a state of well-being in which the individual
ourselves, but there are also times that
realizes his or her own abilities, can cope
we need help from others.
with the normal stresses of life, can work
productively and fruitfully, and is able to
5. Reality Perception (Challenge vs.
make a contribution to his or her community.
Punishment; Motivation vs. Frustration)
(WHO definition)
- has the ability to acknowledge which is
**well-being refers to all aspects.
the reward and the punishment.
**as long as we can cope up in spite of
the stressors, we are in good state of mental
6. Environmental Mastery (Adaptation)
health.
- we tend to master the different factors
- ability of a person to look at his self
surrounding us (the environment that
positively in relation to his role and identified
can cause stress)
existence in society.
**we still have a positive outlook in life
despite presence of stressors.
Mental Illness
- any deviation from what is perceived to be
normal behavioral pattern.
6 Indicators of Mental Health
- failure of a person towards realistic and
1. Positive attitude towards self (Self-
independent means of self-control and
awareness)
coping with the stressors brought about by
- acknowledge that you can do it
different factors.
2. Growth, development, and self-
actualization
- in Maslow’s Hierarchy of Needs, 2nd-5th
levels are related to mental health
3. Integration (Fantasy vs. Reality; Id vs.
Superego)
- fantasy = ideal type
batang_gas
, Psychiatric Nursing LECTURE
TOPIC: Stress and Crisis
Stress - stimulus that produces distress and
creates physical and psychological demands
on an individual, requiring coping and
adapting.
Maladaptive behaviors come from the
inability to cope or adapt to stress.
2. Stage of Resistance
General Adaptation Syndrome (GAS) - physiologic adaptation that attempt to
- by Hans Selye limit damage of stress by stimulating the
- “stress as wear and tear of the body parasympathetic nervous system
occurring regardless of whether the stressor (negative feedback)
is positive or negative.”
3. Stage of Exhaustion
- predictable in terms of s/sx - depletion of physiologic and
- sympathetic, parasympathetic and psychologic resources resulting to failure
endocrine regulates stress response of physiologic process, immune
suppression, diseases, and worst, death.
STAGES:
1. Alarm Reaction
- fight or flight response
How do you cope up with stress?
- reaction of the sympathetic nervous
system and endocrine system to a COPING STRATEGIES
stressor
- 2 classifications: Acute Stress and Coping Strategies (Stress Reduction)
Chronic Stress o Social support
o Self-discipline and perseverance –
help yourself bro
o Vent out strong emotions – the
more you release it, the more eased
that you become (let it go)
o Think of options and problem-
solving techniques
o Physical activities and exercise
o Relaxation techniques (music, warm
bath, meditating, imagery, muscle
relaxation)
Crisis – overwhelming reaction to a stressor
(threatening) where the pt’s problem-
batang_gas
, solving skills is beyond their ability to cope,
adjust, solve, and handle.
It lasts for about 4-6 weeks.
TAKE NOTE:
o All individuals experience problems and
crisis at one time or another.
o Crisis is determined by the individual’s
perception of the problem because each
one uniquely responds to problems.
o Crisis is not necessarily pathological; it
can also stimulate growth and learning. Signs and Symptoms of Crisis:
Physical
Crisis Development (stages):
o Somatic complaints (headache, GI
1. Precrisis period
pain or upset)
- state of emotional equilibrium;
o Appetite disturbance & wt. loss
exposure to stressors but the person
o Sleep disturbances (nightmares,
does not react yet
insomnia)
2. Impact period
o Restlessness, irritability
- failure of coping mechanisms and
Cognitive
manifestations of symptoms of high
o Confusion, difficulty concentrating
level of stress
o Racing thoughts
- inability to reason logically
o Can’t’ make decisions
3. Crisis period
Behavioral
- use of coping skills to deal with the
o Disorganization, withdrawn
stressor (denial, rationalization,
o Impulsive, angry outbursts
projection)
o Difficulty carrying out roles
4. Resolution period
Emotional
- (+) coping = integration; positive
o Anxiety, anger, guilt
perception over crisis; decreased anxiety
o Sadness, depression
and increased self-esteem; resume
o Paranoia, suspicion
social role
o Helplessness, powerlessness
- (-) coping = disequilibrium = tension,
anxiety, depression, self-hate,
decreased self-esteem
5. Post-crisis period Nursing Process: Crisis
- resolution of crisis and return to the Assessment
baseline state of physical and mental
health Types and Cause of Crisis:
- new coping skills 1. Situational – occurs in response to a
sudden, unexpected event that revolve
around experience of loss.
2. Developmental/Maturational – occurs as
part of growth and development transition
batang_gas
, 3. Adventitious – occurs in severe trauma or - active but temporary entry into the life
catastrophic disasters situation of an individual, family, or group during
a period of stress
Based on Severity of Crisis:
- attempt to resolve an immediate crisis when a
1. Class I: Dispositional or Situational Crisis
person’s life goals are obstructed and usual
– acute response with immediate action
problem-solving methods fail
2. Class II: Transitional or Maturational
Crisis – occurs during normal growth and - DIRECT & SUPPORTIVE INTERVENTION
development
3. Class III: Traumatic Crisis – sudden, Direct intervention – take temporary control
unexpected, external stress (loss of home for the situation (you do it for them)
during earthquake, rape) Supportive intervention – collaborative and
4. Class IV: Maturational or Developmental non-directive
Crisis – internal and psychosocial issues
(sexual identity, inability to achieve Crisis Interventions
independence) Establish rapport by active listening
5. Class V: Situational d/t Preexisting Utilize previous effective coping mechanism
Psychopathology – (depression, anxiety) Separate other concerns and solve the
6. Class VI: Psychiatric Emergency – current issue
(attempted suicide, drug overdose, extreme Determine and reinforce correct patterns of
agitation…) thought
Activate the patient’s support system
Characteristics of Crisis: Explore the patient’s idea on self-harm,
o Self-limiting (4-6 weeks) mutilation, or suicide intent (perform suicide
o Resolved in 3 ways: precautions)
- return to pre-crisis functioning
- lead to higher level of functioning PHARMA: anxiolytics (benzodiazepines,
- regress at a lower level of neuroleptics)
functioning
Coping Factors
o Personal perception on the
magnitude of the problem
o Previous experience in managing
and adjusting to the problem
o Coping mechanism and stress mgt.
o Support systems: social or financial
Diagnosis: identify the problem
Outcome: relieve the crisis by promoting coping
mechanism
Crisis Intervention
batang_gas
